Anterior Segment Optical Coherence Tomography in Determination of Entry Site for Vitrectomy in Highly Myopic Eyes

Hirono, Kazushi; Inoue, Maiko; Tanaka, Shin; Uchio, Eiichi; Yanagi, Yasuo; Kadonosono, Kazuaki

doi:10.1097/iae.0000000000003736

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…The same authors also presented an interesting method to determine the distance between the cannula and the fovea and predict in which eyes the surgical instruments would not be able to reach the macula with a standard trocar's position of 3.5 mm from the limbus. 10 In this regard, Hirono et al 11 suggest the preoperative use of anterior segment optical coherence tomography to measure pars plana, comparing it with the intraoperative study of the pars plana to place safely the entry sites further than 4.0 mm to facilitate membrane peeling in highly myopic eyes. Similarly, our working group proposed a new method of preoperative evaluation of the pars plana using ultrasound biomicroscopy (UBM) in eyes with AXL >30 mm.…”

Section: Discussionmentioning

confidence: 99%

Guided trocar insertion in highly myopic eyes

Savastano,

Bernardinelli,

De Vico

et al. 2024

Retina

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Purpose: to demonstrate through a diagnostic test used as a new preoperative assessment, that trocar insertion for pars plana vitrectomy could be safely placed at a distance greater than 4.0 mm in highly myopic eyes to facilitate the surgical maneuvers. Methods: 30 eyes of 30 patients were tested with a biometer for the axial length measurement and with ultrasound biomicroscopy (UBM) to measure the pars plana length. Pars plana lengths of highly myopic eyes were then compared with those of emmetropic eyes. The surgeon also measured the pars plana of highly myopic eyes intraoperatively and compared it with ultrasound measurements to assess UBM reliability. Results: The mean AXL was 23.81mm (SD ±0.30) in the control group and 31.11 mm (SD ±0.56) in the myopic group. The mean pars plana length was 4.96 mm (SD ±0.19) in control eyes and 6.65 (SD ±0.36) in myopic eyes. An extremely significant statistical difference (p < 0.001) was obtained by comparing the length of pars plana between control eyes and myopic eyes. The results of pars plana measurements were 6.65 mm SD ±0.36 (UBM) and 6.66 mm SD ±0.34 (intraoperative measurements) in myopic eyes. The statistical comparison of the measurements in these two groups did not give a statistically significant result (p = 0.950). Conclusions: UBM is a reliable technique to calculate the length of pars plana in highly myopic eyes, where this parameter is significantly greater than that of emmetropic eyes. Trocars insertion for pars plana vitrectomy may be performed, in eyes with axial length greater than 30mm, in relative safety at a distance to limbus higher than 4mm.

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Section: Discussionmentioning

confidence: 99%